Naturalistic observations of pathological behavior in hospitalized psychiatric patients

Naturalistic observations were conducted on 19 acutely ill psychiatric patients in the hospital ward milieu. The study was designed to determine relationships between selected social and environment variables and overt atypical behavior. Patients were observed on an individual basis with time-sampling techniques. In total, 16 pathological behaviors were coded and the most frequent (postural deviance, pace, agitation, hyperactivity, withdrawal, foot shake/body sway, leg swing) were selected in order to determine variation in frequency of these behaviors as a function of the following variables: area within hospital, week of hospitalization, distance between the focal subject and his/her nearest neighbor, number of people in an area, and time of day. Results showed differential changes in pathological behavior as a function of week of hospitalization, number of people in a given area, and distance from the focal subject's nearest neighbor. There was no significant change in the frequency of pathological behaviors as a function of area within hospital or time of day. In addition, most pathological behaviors decreased significantly when patients were engaged in the sending or receiving of verbal behavior. Cluster analyses revealed varying degrees of dissociation between pathological behaviors and social-interaction behaviors. These results support (a) a nonunitary concept of the general category pathological and (b) the view that there are inhibitory effects of social interaction on the enactment of atypical behaviors. Clinical implications of these findings are discussed.R.H.P. completed this research during his tenure as a postdoctocal fellow in the Department of Psychiatry, Human Ethology Laboratory, UCLA (NIMH Fellowship 1 F32MHO7627-01). Support for this research also came from the Veterans Administration.